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The Merit-based Incentive Payment System (MIPS) program was first implemented in 2017 to help identify where physicians are struggling and may require assistance. The program was designed by CMS to update and consolidate previous programs such as Physician Quality Reporting System (PQRS,) Value-Based Payment Modifier (VBM,) and the Medicare Electronic Health Records (EHR) Incentive Program for Eligible Clinicians. As the only publicly available Physician Quality Dataset, MIPS provides performance-based adjustments (positive or negative) to participating clinicians.

Over the course of 2018 and 2019, MIPS reporting requirements, eligibility, and participation guidelines have continued to evolve. Currently performance in the program is measured in four areas—quality, improvement activities, promoting interoperability (formerly ACI – Advancing Care Information) and cost. These four areas make up a final score which determines a clinician’s payment adjustment.

The following list includes the top Physician Groups that received a perfect MIPS score ranked by highest Medicare payment. Of the groups appearing on the list, California has the highest frequency with four groups in the top 25. The specialty with the highest frequency of appearance was family practice with 11 occurrences followed by internal medicine with nine occurrences.

Top 25 Physician Groups by MIPS Score and Medicare Payments:

Physician Group Name

Definitive ID

MIPS Score

Total Medicare Payments

Number of Medicare Procedures

1.

NYC University Physicians Network

577713

100%

$203,431,664

5,055,819

2.

Aurora Health Care Medical Group Inc

550238

100%

$186,348,909

5,076,502

3.

John Muir Health Physician Network

550477

100%

$169,846,307

5,439,559

4.

Beaumont Medical Group

752078

100%

$153,365,926

4,453,224

5.

Palo Alto Medical Foundation

550513

100%

$147,569,905

4,729,815

6.

Atrium Health Medical Group

550275

100%

$146,544,440

4,252,642

7.

Geisinger Clinic Physician Group

550339

100%

$135,424,816

3,005,014

8.

Northern Light Health Physicians

622159

100%

$118,648,319

3,308,725

9.

Santa Clara County IPA

550734

100%

$116,908,313

2,692,611

10.

Our Lady of the Lake Physician Group

550741

100%

$111,984,196

3,084,917

11.

Northwestern Medical Group

552709

100%

$104,271,677

2,690,496

12.

Sentara Medical Group

550585

100%

$102,232,898

1,940,907

13.

St Lukes Physician Group

550612

100%

$100,714,628

1,968,248

14.

Centra Medical Group

550281

100%

$95,583,966

3,005,491

15.

Sutter Medical Foundation

550623

100%

$90,165,252

2,769,055

16.

University of Washington Physicians

551153

100%

$82,532,563

1,451,514

17.

WillsEyePhysicians Mid Atlantic Retina

638563

100%

$81,610,179

364,827

18.

Deaconess Clinic

645915

100%

$76,832,391

1,941,662

19.

Intermountain Healthcare Medical Group

618527

100%

$74,536,394

2,664,754

20.

Prisma Health Physicians

735848

100%

$72,793,296

1,757,955

21.

University of Colorado Medicine

550933

100%

$72,646,479

1,348,385

22.

Valley Physician Enterprise

763733

100%

$70,402,545

1,865,333

23.

SSM Health Dean Medical Group

550314

100%

$69,111,955

2,668,782

24.

Baptist Medical Group

550246

100%

$65,295,380

2,742,496

25.

Sanford Health Medical Group

550880

100%

$62,297,886

1,594,713

Fig 1. Program Year 2017 MIPS Performance Data was released as part of the July 2019 Physician Compare Update. The anticipated release date for MIPS Program Year 2018 data has not yet been released. Medicare data is from the Centers for Medicare and Medicaid Services (CMS) Provider Utilization and Payment Data: Physician and Other Supplier Public Use File (PUF). Calendar Year data is projected to be released each July by the CMS. The most recent data is from calendar year 2017; 2018 data is scheduled to be released in July 2020.